Effect of tetracycline dressing in reducing post-operative complications after impacted third molar surgery

Abstract

Statement of the problem: Surgical removal of mandibular impacted third molars is a routine dental procedure which is associated with the complications such as trismus, swelling, alveolar osteitis, and pain. Furthermore, tetracycline dressings are possibly useful to prevent some of these complications, although this finding requires more investigations. Purpose: This study determined the effects of post-surgical placement of tetracycline impregnated gauze in dental socket to prevent the incidence of the complications related to the surgical removal of impacted third molars in patients referred to Dental School, Tehran University of Medical Sciences, Tehran, Iran. Materials and method: In this split-mouth randomized clinical trial, 27 patients were enrolled. All the patients had bilateral impacted mandibular third molars. A single surgeon extracted all teeth. At the end of surgery, a gauze pack was placed on socket in one side and a tetracycline impregnated mesh in the socket of the other side. The patients were called at 3 rd day after the surgery and the maximum mouth opening and pain were measured and the incidence of alveolar osteitis was recorded. The patients' pain scores were calculated at 2 nd , 3 rd and 7 th days post-surgery by 10-scaled VAS system. The patients' pain scores and the amount of maximum mouth opening were subjected to Wilcoxon Signed Ranks test. Results: There was no incidence of alveolar osteitis in any of the patients. The mean pain scores of the patients after using tetracycline impregnated mesh and gauze pack were 6.07 and 6.59 on 2 nd day, 3.78 and 4.07 on 3 rd day, and 0.19 and 0.33 on 7 th day post-operatively. No statistically significant differences were observed regarding pain scores of the patients in both groups on 2, 3 and 7 days post-operatively. The mean maximum mouth opening of the patients in tetracycline dressing and control groups were found to be 24.11mm and 21.74mm after 3rd day post-operatively which was significantly higher in the tetracycline group than control group (p=0.03). Conclusion: It seems that there is no need to use of tetracycline impregnated mesh in dental sockets following surgical removal of mandibular third molars.